Provider Demographics
NPI:1730137878
Name:SHARMA, ANIL K (MD)
Entity Type:Individual
Prefix:
First Name:ANIL
Middle Name:K
Last Name:SHARMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1967 STATE ROUTE 34 STE 202
Mailing Address - Street 2:
Mailing Address - City:WALL TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:07719-9738
Mailing Address - Country:US
Mailing Address - Phone:732-345-1180
Mailing Address - Fax:732-530-4476
Practice Address - Street 1:1967 STATE ROUTE 34 STE 202
Practice Address - Street 2:
Practice Address - City:WALL TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:07719-9738
Practice Address - Country:US
Practice Address - Phone:732-345-1180
Practice Address - Fax:732-530-4476
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA63404174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJF93426Medicare UPIN
NJSH140391Medicare PIN